Permit CITY OF TIGARD PLUMBING PERMIT
a • COMMUNITY DEVELOPMENT Permit #: PLM2010 -00321
t G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/06/2010
T
Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 487
Subdivision: LINCOLN ONE Lot: 0
Project: Farmers Insurance
Project Description: Interior plumbing: adding (1) 2" hub drain and (1) sink. Other fixture: water heater.
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 1 ea Floor Drain/Floor Sink/Hub 10/06/2010 $25.02
PHONE: 1 ea Sink 10/06/2010 $25.02
1 ea Water Heater 10/06/2010 $37.52
1 12% State Surcharge - 10/06/2010 $10.51
Contractor: Plumbing
POWER PLUMBING CO
PO BOX 19418
PORTLAND, OR 97280
PHONE: 503 - 244 -1900
FAX: 503 - 244 -8825
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $98.07
• Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
-----.-_:) .
Issued By: Permittee Signature: .
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
OCT/04/2010/MON 09:07 AM POURER PLUMBING FAX No.503 244 8825 P. 001
PlumbingPermit Application RECENED it; , d , • ( - •ot
Building Fixtures FOR OFFICE USE ONLY
City of d Ti an >:eeeived
1 114 14 = Tigard OCT 0 C T ) 2 0 0 ' Permit No.:
• 13125 SW H Bl Ti 97223 D j 1 7I Ai 4 so_ .�
Phone: 503.639.4171 Fax 503.598.1 Plan Review
Permit No.:
Inspection Line: 503.639.4175 "� ►" ""' a
In OF TIGARD �tc/BY: v�
Tlcnico ,U IL DINGDIVISIOi Date : ® sa Page z�r
[ ntemet www.tigard d 4 Supplemental Information
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A r -. -. �.,u . •.4 . ...Si'ti � . : j... ,....�. J...w.. :� c..ierl_21.1r.t�- .:.. • Q New construction ❑ Demolition For special information use checklist
Desch on Ea. Total
Addition/alteration/replacement 0 Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
rY 7 „ S y, , . L ' yf a , r t nn . . ,i, 7; ,, s i f`!tl t 41q ii I7.f . 7
...t.. - . :,1 :, :..r, �. :L,L . - ter., 1k"'^ �.�, n _r ?lc - r .a.4:) L , - . i _,.... , ' ...i SFR (I) bath 312.70
❑ 1- and 2- family dwelling Commercial/mdustrial SFR (2) bath 437.78
Accessory building SFR (3) bath 500.32
❑ ry g Q Multi- family .
❑ Master builder Each additional bath/kitchen 25.02
❑ Other
c � z Fire sprinkler sq. ft.) Page 2
? ,2fiiF `.... ..SS. ; 2 1:: -. . e(, ' 7 s i o z: F t r� c I! r s c n ,. r : u' ,,,
„ `a W i-fr, ii ,: :1 -A h 3 , IsT �` " ? �( ' I - r ; ° Site utilities:
' /1.3 J C t . l��� A ,� 1 _ YJ _ t i Catch basin or area drain 18.76
lob Site address: ll�� u >t ,
City/State/ZIP: �( Q► ) �,/ rhea- ?3 Footing rain onl trench drain 1g 2
`'' '� I `4 Footing drain (no. linear R: ) , Page 2
Su 1dgJapt_ no.: 4V-7 I Project name: "r m.e vs ; S ` Manufaca,ted home utilities 50.03
Cross street/directions to job site: Manholes 18.76 ,
O ( Rain drain connector 1 8,76
J te'l Sanitary sewer (no. linear ft.: ) Page 2
' I ` ` �' Storm sewer(no. linear R:._ ) Page 2
•
Water service (no. linear ft.: __) Page 2
$ �,f/` r Lot `► _ � (� 1
Subdivision: . ' Future or item
Tax map/parcel no.: • Backfow preventcr 31.27
' z� 7'" 1. Y e.=N y1 i7 '! y " i "e-"- � 7,4"1'-iii,i r �* y . ^' w, �,7 + Backwater valve °x�'S .era al��C o 1!• , to a' „ g ,�.��, P s s, I aa r ' 12.51
.fu:tu - " �.n.. uo. ti.s. - ! - -',-r nL7:YY � �C - --� ....2.-/z../,.--",.-- ti n.,
s ..•: • ..e _ Clothes Washer 25.02
l. 1 ... '.� P, P a te '
Dishwasher . 25.02
-
' Drinking fountain 25.02
Ejectors/sump 25.02
l ;t 1
` 'r .ii
J .' �" , : A `�8 i3 "'.: :
:;K C ( 17 ere - �;' xp 12.51
:. �i:∎:6•F g .-. '� e nk. . .;... :.4111. - Expansion tank
Na Fixturr/sewer cap 25.02
Floor drain/floor sin ub I 25.02 250r
Address:
Garbage disposal 25.02 .
City/ State/ZIP:
Hose bib 25,02
Phone: ( ) Fax: ( ) Ice maker 12.51
..�C"` , �. . t:47 r :„ � �,p. r � a , iw � Lr s T d dl,1 ,,;717.1. interceptor /grease trap _ 25.02
Business name: I P Medical gas (value: $ ) Page 2
Contact name: Primer 12.51
Roof drain (commercial) 12.51
Up
Address: 1I �:U 811J Sink/basin/lavatory J 25.02 6 t , 2-
City / State/ZIP: 64- d (J f .3
Solar units (potable water) 62.54
Phone: ( ),9 q .. 1 G) U V , I Fax :: ( )).4y - gU. Tub /shower /shower pan 12.51
E -mail: Urinal 25.02
- r, t 'tw �, . �s Water closet 25.02
i � .'Nrr .at ::::,•. L }t. c� S. KiL� .. .... ' .{ .
t . 7 it, "'� c 4. Water heat
'` er / 37.52 91/
Business name: / 0 I 1 : Water piping/DWV 56.29
1 y �
D J
Address: Q I b _ Other: 25.02
City /State/ZIP: pvJ--,t4
- � aV . G i `7 �. Subtotal 7 $ i�
Phone: (5) X +4 _ ( Fax: ( ) •I -4 ) ,5 Minimum permit fee: $72.50
CCB Lic.: 5 2j4' Plumbing Lic. n -: I �
Plan review (25% of permit fee)
State surcharge (12% of permit fee) I t ! 5(
Authorized signature: TOTAL PERMIT FEE CIA 17'l
Prim name: - 1 ,�5+ Date: , Thts permit application expires tie permit is not obtained withia I8o' daya
after It has been accepted as complete. . � - i • v
sr • 'Pee methodology set by Tri- County Building Industry Service t �3� J
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OCT /04 /2010 /MON 09:07 AM POURER PLUMBING FAX No,503 244 8825 P. 002
•
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule Residential Fire Su • • ression
S stems
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( dl ; .ii r..:. Z.' 4:� . {vi !r ler '�e'e9Zf2 _ }'�� ' �'ti'Zw''_�i�4 7�
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Footing drain • l a 100' _ 50.03 0 to 2 000 5121.90
Footing drain -each additional 100' 37.52 2 001 to 3.600 $169.69
3,601 to 7 200 $233.20
Sewer • 1st 100' 62.54 7.201 and er $327.54
Sewer - each additional 100' 37.52 M
Water Service. 1st 100' 11;01 Medical Gas S stems:
Water Service - each additional 100' 37.52 . N; h m r `- �- t�
Storm & Rain Drain - 1st 100' ' '�!�T. 4 ,...a� . ? ', 'S �,K, s � ,: -... . 6 ,.. ' ` , _.. , J
$1.00 to 55,000.00 Minimum fcc $72.50
Storm &Rain Drain - each additional 100' �_ 37 52 ' 55,001.00 to 510,000.00 $72.50 for the first 55,000.00 and $1.52 for
W`tj
1 .' _- rte=.'_ " ��! �. r..: v c�F�....s` -�" r„ each additional l $100.00 or fraction thereof, to
and including $10,000.00.
Inspection of existing plumbing or for . ■ 5I0,001.00 to $25,000.00 514830 for the first $10,000.00 and 51.54 for
which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof to
minimum ch: a -112 hour and includin: $25 000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to 550,000.00 5379.50 for the first $25,000.00 and $1 AS for •
hours minimum - . :e -2 hours each additional 5100.00 or fraction thereof, to
Rcinspection Fees _ 90.00/hr IIII. and including $50,000.00,
Additional plan review for revisions 90.00/hr 550,001.00 and up $742.00 for the first $50,000.00 and $120 for
minimum char: —1/2 hour each additional 5100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ", _ s i ° '- r } i ,t a lraWA 3 W , ,,' I rrj
please indicate work performed by fixture. Failure to Plan review is required for any of the following.
accurately report fixtures could result in increased sewer fees * . Please check all that apply.
s: r el... :` "2�4 aliiR ' rim Wi
e ii'k?IFFr'f6rnietrtli 2" ❑ Any new commercial building with water service and
?�a � a iC! ' tv it u I j �'� qi Replaod,',. greater, except systems designed and stamped by licensed •
* < ,.:� , -z ti u r , a . s. engineer.
Baptistry/Font ❑ New exterior plumbing site utilities for any complex structure '
Bath -Tub/Shower as defined in OAIt918- 780 0040.
-Jacuzzi/Whirlpool
Car Wash • Stall ❑ Medical gas and vacuum systems for health care facilities.
-Drive Thn, ❑ Any multipurpose fire sprinkler system.
Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040.
Dishwasher - Commercial
Domestic Submit 2 sets of plans with any of the above.
Drinking Fountain
Eye Wash t, ° .c
za ". r i i I ! '�? l i. 6.0. r: A r :.;»ir f s
Floor Drain/sink 2" J 1 ❑ Isometric or riser diagram is required for new buildings V
4° that meet the qualifications above.
Car Wash Dram
Garbage - Domestic
Disposal - Commercial
- Industrial Comments regarding fixture work:
Ice MachJRefrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall •
Sink - Bar/Lavatory —.—L_
- Bradley
commercial *Note: If the fixture work under this permit results in an
- Service increase of sewer -EDUs, a sewer permit will be issued and
Swimming Pool Filter fees assessed for the sewer increase must be paid before the
Washer • Clothes p
water Extractor plumbing permit can be issued.
Water Closet - Toilet
Urinal AL,
Other Fixtures: ' Nob,- 1
http:/ /www,tigard- or.gov/ city_ ha ll/departmcnts /cd/docs/PLMF- PermitApp2doc